Provider Demographics
NPI:1497365688
Name:GARCIA PEREZ, CLAUDIA M
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:M
Last Name:GARCIA PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 W CARMEN ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1708
Mailing Address - Country:US
Mailing Address - Phone:305-440-7362
Mailing Address - Fax:
Practice Address - Street 1:2413 W CARMEN ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1708
Practice Address - Country:US
Practice Address - Phone:355-440-7362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician